Surgical series of 42 children operated on for symptomatic cavernous malformations of the central nervous system (35 brain supratentorial lesions, 5 infratentorial, and 2 in the spinal district), in a period of 30 years, has been analysed, comparing results with the most recent literature data dealing with pediatric cavernous malformations of the neuraxis. In this series, surgery allowed excellent and good results in 69% of our 42 children. Unchanged neurological deficits were observed in 23.8% of cases, while morbidity from surgical procedures resulted in 7.14% of cases. Mortality was absent in this series. The main clinico-diagnostic features, risk factors, and associated diseases of cavernous malformations, also called cavernous angiomas or cavernomas, of the central nervous system in children are discussed, remarking the most relevant differences respect to the affected adult population, and focusing the management of pediatric patients harbouring cranial and spinal cavernomas. We concluded that: cavernous malformations represent the most common central nervous system vascular lesions in children, although their incidence is four times lower than in adult population. The natural history of pediatric cavernous malformations throughout the neuraxis seems to be more aggressive than in adult patients, showing lesions higher rates of growth and hemorrhage, larger dimensions, and often atypical radiological pictures at diagnosis. Beside the familiar form of the disease, more often associated to multiple lesions and an earlier age of clinical presentation, the major risk factor for developing cavernous malformations in children seems radiotherapy for CNS tumors. Furthermore, coexistent cavernous malformations with mixed angiomatous lesions have been reported in children more than in adults. Surgical results are related to the preoperative neurological status of children: symptomatic patients who are operated on early, before they develop severe neurological deficits, or long standing seizures, may achieve the best clinical outcome. Radiosurgery seems to be not advisable in children as alternative treatment of deep lesions, or those causing epilepsy.
|Translated title of the contribution||Cavernous malformations of central nervous system in paediatric age|
|Number of pages||28|
|Journal||Rivista Italiana di Neurobiologia|
|Publication status||Published - 2008|
ASJC Scopus subject areas
- Clinical Neurology